| NPI | 1780960724 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PATRICIA LIGGETT Office Manager 678-210-1166 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 033610 GA) | 
| Enumeration Date | 2011-10-21 | 
| Last Update Date | 2011-10-21 |